1447668710 NPI number — CHRISTINE LEE STANTON, M.S., CCC/SLP

Table of content: (NPI 1447668710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447668710 NPI number — CHRISTINE LEE STANTON, M.S., CCC/SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTINE LEE STANTON, M.S., CCC/SLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447668710
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3300 IRVINE AVE
Provider Second Line Business Mailing Address:
SUITE 111
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660-3109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-922-7703
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
445 ENCLAVE CIR
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
COSTA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92626-8214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-922-7703
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
STANTON
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
SPEECH-LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
949-922-7703

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X , with the licence number:  SP9045 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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